Glycemic control and microvascular complications in adults with type 1 diabetes and long-lasting treated celiac disease: A case-control study

Creanza, Annalisa; Lupoli, Roberta; Lembo, Erminia; Tecce, N; Pepa, Giuseppe Della; Lombardi, Guido P.; Riccardi, Gabriele; Bonito, Procolo Di; Capaldo, Brunella

doi:10.1016/j.diabres.2018.07.031

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…This is contrary to reports of higher doses of insulin in CD patients. 35 Some authors observed the lower need of insulin during the first 2 years following the diagnosis of CD in T1D children than in non-CD patients 36 and, interestingly, in children without CD following a gluten-free diet during the first 12 months after diabetes diagnosis. 37…”

Section: Discussionmentioning

confidence: 99%

Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

Taczanowska

Schwandt

Amed

et al. 2020

Journal of Diabetes

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Background: Children with type 1 diabetes (T1D) are at much higher risk of developing celiac disease (CD) than the general population. The aim of the study was to assess the prevalence and differences in clinical presentation of CD in T1D in different regions of the world. Methods: This study is based on the Better control in Pediatric and Adolescent diabeteS: Working to crEate cEnTers of Reference (SWEET) database. There were 57 375 patients included in the study, aged ≤18 years from 54 SWEET centers. Only centers with screening for celiac disease were included. Regression models adjusted for age, diabetes duration, and gender and a fixed effect in the models for region was used. Diabetes duration, age at diabetes onset, and sex were presented as unadjusted results. Results: CD was present in 2652 subjects (4.5%), with different prevalence among regions: from 1.9% in Asia/Middle East to 6.9% in Australia/New Zealand. CD was observed more often among females. Comparing children with and without CD, characteristics for those with CD were younger age at diabetes onset (6.3 [3.3; 9.8] vs 8.1 [4.6; 11.3], P < 0.001) and had longer diabetes duration (6.4 [3.6; 9.8] vs 4.8 [2.1; 8.2], P < 0.001). Further, they had lower glycosylated hemoglobin (HbA1c) in Europe and North America/Canada; lower body mass index (BMI)-SD score (BMI-SDS) in southern Europe, North America, and Canada; In most regions daily insulin dose was lower, height-SDS was lower, and the percentage of insulin pump users was higher in children with T1D and CD. Conclusions:The prevalence and the anthropometric and metabolic consequences of CD in children with T1D differ around the world.

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Section: Discussionmentioning

confidence: 99%

Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

Taczanowska

Schwandt

Amed

et al. 2020

Journal of Diabetes

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“…The effect of CDAb on β-cell function in T1D patients is currently unclear. In addition, CDAb also has an uncertain role in insulin dosage, as some authors observed a lower need for insulin during the first two years following the diagnosis of CD in T1D children than in non-CD patients (4, 24), while a higher DID was found to be associated with CDAb positivity (25). Interestingly, among the five candidate circRNAs from the general T1D patients in the GEO database, only the expression of hsa_circ_0004564 in the CDAb + group was found to be lower than that in the CDAb − group, while the expression of hsa_circ_0004564 was upregulated in the general T1D population, suggesting that the expression in the CDAb − group was more obviously upregulated.…”

Section: Discussionmentioning

confidence: 99%

Circulating circular RNA profiles associated with celiac disease seropositivity in children with type 1 diabetes

Zhang

Wang

et al. 2022

Front. Pediatr.

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IntroductionThe frequency of celiac disease autoantibody (CDAb) positivity in type 1 diabetes (T1D) has increased due to unclear mechanisms, including autoimmune injury. Circular ribonucleic acids (circRNAs) participate in autoimmune diseases, but the roles of circRNAs in T1D with CDAbs are currently unknown. This study aimed to determine the frequency of CDAbs in Chinese children with T1D and describe the relationship between CDAbs and circRNAs.Materials and methodsEighty patients diagnosed with T1D were screened for CDAbs and CD-predisposing genes, and circRNAs in peripheral blood mononuclear cells (PBMCs) were collected from 47 patients. The Gene Expression Omnibus (GEO) database was searched for candidate circRNAs in related studies on T1D PBMCs. Data on clinical characteristics (i.e., blood glucose control, residual islet function, and daily insulin dosage) and immunophenotypes (i.e., islet autoantibodies and immune cell subsets) were collected.ResultsIn total, 35.0% of patients were positive for CDAbs. CD-predisposing genes accounted for 52.5% of the genes, and no significant difference in frequency was found between the CDAb-positive (CDAb+) and CDAb-negative (CDAb–) groups. In addition, among the differentially expressed circRNAs from the GEO database, five highly conserved circRNAs homologous to humans and mice were screened, and only the expression of hsa_circ_0004564 in the CDAb+ group significantly decreased (CDAb+ vs. CDAb–:1.72 ± 1.92 vs. 11.12 ± 8.59, p = 6.0 × 10–6), while the expression of hsa_circ_0004564 was upregulated in the general T1D population. Moreover, its parental gene RAPH1 was significantly upregulated (CDAb+ vs. CDAb–:1.26 ± 0.99 vs. 0.61 ± 0.46, p = 0.011). Importantly, the positive correlation between hsa_circ_0004564 and CD3+ cells was validated in children with T1D after adjustments for CDAbs (p = 0.029), while there were no correlations between hsa_circ_0004564 and clinical characteristics or other immune cell subsets (i.e., CD4+ T cells, CD8+ T cells, and natural killer cells).ConclusionThis study highlights the importance of screening for CD in Chinese children with T1D, considering the high prevalence of CDAb positivity and CD-predisposing genes. The profile of candidate circRNAs in children with T1D with CDAbs was different from that in previous reports on general T1D patients from the GEO database. Moreover, hsa_circ_0004564 and its parental gene RAPH1 may be new targets for studying immune mechanisms in children with T1D and CD.

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“…Creanzo et al [ 56 ] investigated, in a case–control study, whether in T1DM patients the coexistence of long-lasting CeD treated with a GFD impacts glycemic control and the incidence and severity of microvascular complications. They concluded that GFD neither worsened glycemic control nor negatively influenced the incidence of chronic microvascular complications.…”

Section: Effect Of Gluten Free Dietmentioning

confidence: 99%

“…Creanzo et al [ 56 ] found that the coexistence of T1DM and CeD is associated with lower eGFR values than those with T1DM alone.…”

Section: Micro- or Macroangiopathic Complications In Coexistent T1dm ...mentioning

confidence: 99%

Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life?

et al. 2022

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Celiac disease (CeD) is associated with type 1 diabetes mellitus (T1DM), and both have the same genetic background. Most patients with T1DM who develop CeD are either asymptomatic or have mild CeD-related gastrointestinal symptoms. Therefore, children affected by T1DM should undergo screening for asymptomatic CeD. The aim of this review is to highlight the influence of a gluten-free diet (GFD) on glycemic control, growth rate, microvascular complications, and quality of life in patients with T1DM and CeD. PubMed, Google Scholar, Web of Science, and Cochrane Central databases were searched. Reports reviewed were those published from 1969 to 2022 that focused on the interplay of T1DM and CeD and examined the effect of diet on glycemic control, growth rate, and quality of life. The most challenging aspect for a child with T1DM and CeD is that most GFD foods have a high glycemic index, while low glycemic index foods are recommended for T1DM. Interestingly, dietary therapy for CeD could improve the elevated HbA1c levels. Avoiding gluten added to a diabetic dietary regimen in T1DM patients might impose practical limitations and lead to important restrictions in the lifestyle of a young patient. Consequently, non-adherence to GFD in patients with T1DM and CeD is common. GFD in patients with T1DM and CeD seems to lower the incidence of micro- and macrovascular complications, but this requires further investigation. It seems that adherence to GFD in young patients with T1DM and CeD leads to regular growth and a stable body mass index without any negative effect on HbA1c or insulin requirements. Furthermore, the lipid profile and quality of life seem to have improved with the introduction of GFD.

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Glycemic control and microvascular complications in adults with type 1 diabetes and long-lasting treated celiac disease: A case-control study

Cited by 9 publications

References 34 publications

Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

Celiac disease in children with type 1 diabetes varies around the world: An international, cross‐sectional study of 57 375 patients from the SWEET registry

Circulating circular RNA profiles associated with celiac disease seropositivity in children with type 1 diabetes

Gluten-Free Diet in Co-Existent Celiac Disease and Type 1 Diabetes Mellitus: Is It Detrimental or Beneficial to Glycemic Control, Vascular Complications, and Quality of Life?

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